From Mpls—one way to work around ICE’s affect on health care-
Pediatric visits with Park Nicollet/Health Partners: 🏥
🩺 Currently Park Nicollet/ Health Partners pediatricians are offering video visit for any families who cannot safely come into the clinic, regardless of complaint (except well child visits). Even those without insurance can be seen.
If at the video visit it is determined a child needs to be seen in person. Any adult can accompany the child to the visit with parents available on the phone at time of visit to confirm consent for treatment. If it is not possible for the parent to be available by phone. Written consent for treatment can be sent with the child.
I'm curious about the data on office visits. The combined home tests can make office visits unnecessary--I tested positive for Flu A, called the doctor, and got Tamiflu prescriptions for me and my husband, who never even tested but obviously had what I had. Does a phone call ending in a prescription get reported as an office visit? And more generally, while the home tests are fantastic (they include COVID and RSV too!), are they skewing the data on ILI office visits?
Ohhh that's a great question. It doesn't necessarily need a test, but your physician does have to mark in your chart that you have a fever, cough, or sore throat. So if s/he did that after you called, you would be counted.
I could be mistaken but the last I heard, influenza like illnesses have no mandatory reporting process to public health entities. Further, I am unaware that checking a box or making an entry into a patient’s electronic health record is automatically provided to public health entities. Venereal disease diseases, hepatitis, HIV, measles etc. are reportable of course. Thank you.
F/u from my previous comment: there is no EHR Connection from one office to the next nor office to public health servers unless each entity uses the same software. That isn’t the reality although it was the intent to make data accessible across platforms. My PCP in a private office has an entirely different EHR system than the main hospital system, or a local private dermatology office, for example. EPIC is a common EHR utilized by large systems throughout the country but it requires substantial resources with interfaces that private offices cannot afford.
* In North Carolina, physicians are *not* required to report every case of influenza‑like illness (ILI). What is required is reporting laboratory‑confirmed influenza deaths and certain severe or unusual influenza cases to the local health department. Routine ILI cases seen in outpatient settings are tracked through voluntary surveillance systems, not mandatory physician reporting. (AI search)
Thank you for sharing the supplement alert. I had not seen that previously. I hope that is something you will continue to share. Also, I appreciate the EPA policy update. You and your team are doing an outstanding job of keeping us updated about critical changes like that which might otherwise fly under the radar with all of the other attention-grabbing news of this administration. Thank you, thank you, thank you!
And the ill-informed, malicious Secretary Kennedy stays in place, making poor decisions that will compromise the health of many over the next few years. Where are the checks and balances on him?
As a clinician, seeing the ILI chart trend down gives me some hope, but I can tell you it does not FEEL like things are slowing down yet here in MA. Starting to see more flu B and, unfortunately, RSV. In addition to norovirus, lots of strep and still flu A. The joy of winter in peds! 🫠
Our current situation in Public Health (and the world) is certainly a time of significant grief. Grief is about so much more than death - it's about change; loss of hopes, dreams and expectations; things we wish were different, better or more (or in the case of ICE - less!). I have a contract through the Association of Ohio Health Commissioners (our state SACHO) with funding from the Ohio Dept of Health, to address grief as a Public Health issue - and within the Public Health workforce. One of the things I've done a lot of - is webinars for Public Health staff - to help them understand these issues as grief events. If you'd like to know more about what I'm doing in Ohio - or how I might help you in your area - please contact me at lhall.eachmatters@gmail.com. Here's a link to a recent article from NACCHO - they call it burnout - I call it grief. https://pmc.ncbi.nlm.nih.gov/articles/PMC12622263/ Thanks so much to Your Local Epidemiologist for your info and encouragement. At times like these - we need each other even more - thanks for keeping the connection!
I love your assessment that hanging out with the piranhas was better than being in country. I agree and feel that our current leaders have the moral code of the average piranha. Thank you again for your clear and honest reporting.
Now would be an important time to talk about mental health, dementia, narcissism, psychosis and other mental issues that will have a huge impact on all of us. In the meantime, listen to this song direct from Minneapolis. The ghost of Phil Ochs is speaking to America. "Knock on the door, knock on the door, here they come to take one more!"
How sensitive are the rapid tests for current flu virus? I’m 69 and had classic flu symptoms, but tested negative for flu and covid. My Dr. would not prescribe an anti-viral without a positive test.
Great question! So at-home tests are less sensitive than the lab tests run at clinics. Studies estimate sensitivity for at-home flu tests is about 60%, even less if it's a combined flu/Covid-19 test. Accuracy also depends on how quickly you take the test after you start to feel symptoms. It's best to take them within the first 72 hours, since viral load decreases after that, making it harder for the test to pick up.
Given a person actually has flu, they'll test positive 60% of the time. So yes, 40% of the time, the test will come back negative even if someone has the flu. (False positives are uncommon.)
There are a number of different combined tests, so can't definitively say how much worse is any one. There are data as low as 40% for flu, but with a higher sensitivity for Covid-19 (vs. flu, in the same test).
1. As a primary care clinician in southern Oregon, I just diagnosed Flu A for the first time this season 2 days ago and our ERs are just starting to see a rise. Is there a regional chart for influnza like there is for COVID?
2. I live/practice in one of the least vaccinated areas of the country. Our measles outbreak risk is high. I appreciate the map by zip code and county. I would be curious to see risk in map form with population density layered. Looking at the map nationally it seems many of the highest risk areas are fortunately lower population, at least in the mountain west/Pacific coast states. Does anyone have mapping with population density layered on top of vaccine rated?
From Mpls—one way to work around ICE’s affect on health care-
Pediatric visits with Park Nicollet/Health Partners: 🏥
🩺 Currently Park Nicollet/ Health Partners pediatricians are offering video visit for any families who cannot safely come into the clinic, regardless of complaint (except well child visits). Even those without insurance can be seen.
If at the video visit it is determined a child needs to be seen in person. Any adult can accompany the child to the visit with parents available on the phone at time of visit to confirm consent for treatment. If it is not possible for the parent to be available by phone. Written consent for treatment can be sent with the child.
From our local community support chat.
I'm curious about the data on office visits. The combined home tests can make office visits unnecessary--I tested positive for Flu A, called the doctor, and got Tamiflu prescriptions for me and my husband, who never even tested but obviously had what I had. Does a phone call ending in a prescription get reported as an office visit? And more generally, while the home tests are fantastic (they include COVID and RSV too!), are they skewing the data on ILI office visits?
Ohhh that's a great question. It doesn't necessarily need a test, but your physician does have to mark in your chart that you have a fever, cough, or sore throat. So if s/he did that after you called, you would be counted.
I could be mistaken but the last I heard, influenza like illnesses have no mandatory reporting process to public health entities. Further, I am unaware that checking a box or making an entry into a patient’s electronic health record is automatically provided to public health entities. Venereal disease diseases, hepatitis, HIV, measles etc. are reportable of course. Thank you.
Correct, it's not a mandatory report like measles. This uses a different epi method called syndromic surviellence
I can confirm no mandatory reporting for influenza-like illness in Ohio.
I used to be epi for a local health department.
F/u from my previous comment: there is no EHR Connection from one office to the next nor office to public health servers unless each entity uses the same software. That isn’t the reality although it was the intent to make data accessible across platforms. My PCP in a private office has an entirely different EHR system than the main hospital system, or a local private dermatology office, for example. EPIC is a common EHR utilized by large systems throughout the country but it requires substantial resources with interfaces that private offices cannot afford.
* In North Carolina, physicians are *not* required to report every case of influenza‑like illness (ILI). What is required is reporting laboratory‑confirmed influenza deaths and certain severe or unusual influenza cases to the local health department. Routine ILI cases seen in outpatient settings are tracked through voluntary surveillance systems, not mandatory physician reporting. (AI search)
Here's a little video from Randy Rainbow using humor to highlight the insanity in current public health circles…
https://www.youtube.com/watch?v=lDHpbnbmaME&list=RDlDHpbnbmaME&start_radio=1
This is fantastic!
Thank you for sharing the supplement alert. I had not seen that previously. I hope that is something you will continue to share. Also, I appreciate the EPA policy update. You and your team are doing an outstanding job of keeping us updated about critical changes like that which might otherwise fly under the radar with all of the other attention-grabbing news of this administration. Thank you, thank you, thank you!
And the ill-informed, malicious Secretary Kennedy stays in place, making poor decisions that will compromise the health of many over the next few years. Where are the checks and balances on him?
Slow but coming. I appreciated this article yesterday: https://www.washingtonpost.com/health/2026/01/19/rfk-childhood-vaccines-lawsuit/
Thank you for the encouragement. As a physician, consumer, and frightened person, it is coming all too slowly.
As a clinician, seeing the ILI chart trend down gives me some hope, but I can tell you it does not FEEL like things are slowing down yet here in MA. Starting to see more flu B and, unfortunately, RSV. In addition to norovirus, lots of strep and still flu A. The joy of winter in peds! 🫠
Our current situation in Public Health (and the world) is certainly a time of significant grief. Grief is about so much more than death - it's about change; loss of hopes, dreams and expectations; things we wish were different, better or more (or in the case of ICE - less!). I have a contract through the Association of Ohio Health Commissioners (our state SACHO) with funding from the Ohio Dept of Health, to address grief as a Public Health issue - and within the Public Health workforce. One of the things I've done a lot of - is webinars for Public Health staff - to help them understand these issues as grief events. If you'd like to know more about what I'm doing in Ohio - or how I might help you in your area - please contact me at lhall.eachmatters@gmail.com. Here's a link to a recent article from NACCHO - they call it burnout - I call it grief. https://pmc.ncbi.nlm.nih.gov/articles/PMC12622263/ Thanks so much to Your Local Epidemiologist for your info and encouragement. At times like these - we need each other even more - thanks for keeping the connection!
I love your assessment that hanging out with the piranhas was better than being in country. I agree and feel that our current leaders have the moral code of the average piranha. Thank you again for your clear and honest reporting.
Now would be an important time to talk about mental health, dementia, narcissism, psychosis and other mental issues that will have a huge impact on all of us. In the meantime, listen to this song direct from Minneapolis. The ghost of Phil Ochs is speaking to America. "Knock on the door, knock on the door, here they come to take one more!"
https://www.youtube.com/watch?v=pt8JceZdITk
How sensitive are the rapid tests for current flu virus? I’m 69 and had classic flu symptoms, but tested negative for flu and covid. My Dr. would not prescribe an anti-viral without a positive test.
Great question! So at-home tests are less sensitive than the lab tests run at clinics. Studies estimate sensitivity for at-home flu tests is about 60%, even less if it's a combined flu/Covid-19 test. Accuracy also depends on how quickly you take the test after you start to feel symptoms. It's best to take them within the first 72 hours, since viral load decreases after that, making it harder for the test to pick up.
Does this mean a 40% false negative rate?
Also, how much worse is the combined test?
Given a person actually has flu, they'll test positive 60% of the time. So yes, 40% of the time, the test will come back negative even if someone has the flu. (False positives are uncommon.)
There are a number of different combined tests, so can't definitively say how much worse is any one. There are data as low as 40% for flu, but with a higher sensitivity for Covid-19 (vs. flu, in the same test).
Note it's not just lower income communities adjacent to point polluters that suffer from EPA's new lack of constraint.
In the DC Metro area for example, we will be hammered if dirty coal is processed in Pennsylvania, two states away. Air moves.
If you are too young to remember the founding of the EPA, read this.
https://www.history.com/articles/epa-earth-day-cleveland-cuyahoga-river-fire-clean-water-act
A bit late here, 2 questions:
1. As a primary care clinician in southern Oregon, I just diagnosed Flu A for the first time this season 2 days ago and our ERs are just starting to see a rise. Is there a regional chart for influnza like there is for COVID?
2. I live/practice in one of the least vaccinated areas of the country. Our measles outbreak risk is high. I appreciate the map by zip code and county. I would be curious to see risk in map form with population density layered. Looking at the map nationally it seems many of the highest risk areas are fortunately lower population, at least in the mountain west/Pacific coast states. Does anyone have mapping with population density layered on top of vaccine rated?
Thanks for your excellent reporting as always!!
Thank you for these updates. The data snapshots, concise and readily comprehensible analyses, and recommendations are greatly appreciated!
FYI here’s a dhs link regarding who ICE is prioritizing in Minnesota as well as other sanctuary cities.
https://www.dhs.gov/wow
Correction needed: your chart is called Monthly opioid deaths, but it’s annual (all deaths for the period ending jan of each year).
I don't know if it's necessarily "good news" when there's moderation in some past, terrible news.
It should be non-news when beneficial funding continues year-on-year. Moving a funding needle from "bad" toward "non-news" isn't truly awesome.